I am aware what intersex is. A child cannot consent to anything, so I don’t see a reason to ban medical interventions — there’s procedures involving doctors and parents before such things are considered.
Wikipedia cites https://web.archive.org/web/20210425173353/https://bufdir.no..., which I cannot read easily, but which you may find interesting. (Unlike Bergamot, Firefox Translation has no Norwegian support, but the Swedish model tries really hard.)
The problem is that drawing this line isn't always simple. Make the law too strict, and you can just as easily end up barring doctors from performing surgeries that by their correct case-by-case judgement is necessary, but the law prohibits because it necessitates, say, medical consensus in general. But make the law too lax and you open the doors to purely cosmetic surgeries which I am absolutely against.
What we cannot have is the ability for children whom cannot legally make medical decisions be allowed to start things like gender-affirming care. Because if we can't trust them with other less life-altering choices, how could we trust them with that? Especially given how easily influenced children are.
The trouble I have with this reasoning, though, is it's asymmetrical. We don't allow trans kids access to exogenous sex hormones because cis kids might hypothetically be being influenced by their parents / other authority figures to make a bad decision (e.g. Munchausen syndrome by proxy), but we know there's pressure on trans kids to repress and pretend to be cis (we have statistics about it), so why do we let any children go through puberty? How can we trust them with that? (Yes, this thought experiment is somewhat ludicrous, but why is it ludicrous?)
For most people who experience it, gender dysphoria is distressing and hard to ignore. Most cis people can be put in situations where they experience it, and they report the same intense feelings of distress. I doubt you could easily influence many 12-year-olds to push through those feelings – though I'm not sure how one might test this ethically, so I'm not sure what studies to look for. Norway's current approach seems suitably-conservative to me. (And I don't see any advantage, even hypothetically, to forcing trans people into binary classifications: that seems like the "rigid gender roles" problem rearing its head again.)
P.S.: You're considerably more reasonable about this than I initially thought: thinking about the right things, for the right reasons, such that with complete information I'd expect you to come to the right decisions. I long to have people like that for political opponents.
Also puberty is a natural function of the human body. We can only do our best to support children going through it, but it's not even worth contemplating whether we should "let" a child go through it or not. That makes no biological sense. For better or worse, humans are mammals whose offspring require _significant_ amount of care for much longer than any other mammal. We might not like it on a theoretical level, but practically speaking and evolutionarily, parents are responsible for their children until their children come of age.
When it comes to legitimate trans kids the aim should be education of and societal support of parents to be as informed as possible, not to circumvent them if some _other_ adults deem it necessary. A doctor is not the legal caretaker of a child, only the parents are.
> puberty is a natural function of the human body
The onset of puberty is way earlier than it used to be. Per http://www.mum.org/menarage.htm, "In 1860 the average menarche happened at 16.6 years,"; per https://www.thetimes.com/uk/science/article/girls-now-begin-..., "Girls now begin puberty aged 9". Delaying puberty until age 16 could be argued as the more natural stage (though I take such arguments 'round back, and beat them to death, especially if they support my beliefs: the naturalistic fallacy is too seductive to listen to).
> That makes no biological sense.
Biologically, there's no reason* we couldn't make them wait until adulthood to begin puberty. You've not quite identified where the ludicrousness is – though you're close.
Past that point, I think you're doing what I did earlier, and arguing against a position I haven't taken. (Unfortunately, I'm less eloquent than you, so I'd spend several paragraphs if I were to correct you: I'll trust in your ability to work it out.)
> the aim should be education of and societal support of parents to be as informed as possible
A thousand agreements: this is the ideal. All other situations are pathological special-cases – though, like antivax parents, they're special-cases that the medical system does have to take into consideration. (I don't know whether you have a general-purpose equivalent of Gillick competence in Norway, but see https://learning.nspcc.org.uk/child-protection-system/gillic....)
This isn't a point I've been trying to focus on, since it follows once correct handling of the ideal "everyone's informed and with the child's best interests at heart" case is established.
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*: Biiiig asterisk here: abnormal pubertal timing is associated with health problems (see https://www.endocrinology.org/endocrinologist/134-winter19/f... and citations), but we don't have solid data on the arrow of causation, nor good data on confounders (social attitudes seem to be a problem in the US, and https://doi.org/10.1542/peds.2005-2939 strongly suggests that social/psychological effects have a big impact on onset of puberty), so that would be a separate point. There are no known problems caused by the use of GnRH modulators to postpone puberty (except low bone density, which per https://doi.org/10.3389/fped.2022.968485 and https://doi.org/10.1210/jcem.87.2.8202 is temporary and goes away in puberty, and per https://doi.org/10.6061/clinics/2012(06)08 doesn't occur at all – and can be ameliorated with calcium and vitamin D supplementation), and afaik there's no theoretical expectation of such problems (except, again, bone density: I'm not sure that anyone knows why that isn't more of an issue, since it is sometimes an issue when GnRH modulators are used post-puberty – though the patient information leaflets I've read still stress the treatment as extremely safe in adults (with more assurance than I'd have given, but hey, I'm not an expert)). For the sake of the thought experiment, please pretend there are no such issues.
My instinct tells me that _if_ the age is sliding, then the first place to look is where we've made the biggest human interventions already. Vaccination -- and no I'm not anti-vaccines, but like any medicine, these have various side-effects -- and likely significantly more important, food and additives. In Norway we do not allow growth hormones in feed for livestock that is to be consumed by humans; could that be a contributing factor elsewhere?
Before we even start contemplating compounding these things with even more interventions we have to seriously look at what we've been doing already. This is a fundamental flaw in a lot of western medical practices these days: We see a symptom. We treat the symptom with a new intervention instead of first changing habits like food, activity, etc. The new intervention then has side effects causing symptoms we treat with another intervention. And on and on.
I've experienced this myself, with side-effects of antihistamines being treated with proton pump inhibitors which causes digestive issues that led to other problems. Eventually I just had to read up on everything myself and figure out the root cause because the doctors -- and I went to _many_ -- just kept sending me to new investigative procedures and added more medication. When the solution all along was to just taper off antihistamines at the end of allergy season.
I see the same in my entire family, and with friends. And Norway's healthcare system is apparently among the better of the world, which I find hard to believe.
The things you say were sort of true two years ago, and I'm confident you'll be able to make them true again, but it will be an uphill battle.
No, they accounted for that sort of thing when working out the estimates.
> My instinct tells me
I think your instincts are correct. Available resources seem to be one of the dials by which the onset of puberty is calibrated. Modern children suffer less from malnutrition, which means earlier puberty.
But your instinct is badly-calibrated. You should research the topic in detail, before believing you know anything about it. Vaccines, food, and additives? Growth hormones aren't allowed in feed in the UK, and that's where my "9 years old" figure came from. You're right to speculate, but this speculation is all wrong. Instead, you should look in the direction of plastic additives, which are known to be endocrine disruptors: we don't have much evidence that those are the cause, but that was my first guess after reduced malnutrition, and it's also the guess of the author of the paper linked in my previous comment.
It's fortunate for you that your instincts are broadly correct, since this means you can learn more about the topic without much risk of cognitive dissonance: you can keep your mind open, without risking your worldview. For those of us for whom this is more personal, this knowledge is hard-won. (Sure, after the fact, knowing that reality agrees with what I needed to be true – with a few irritating exceptions –, it doesn't seem like a big deal. Indeed, the fact that I needed these things to be true, without first deciding that, was strong evidence that there was a real phenomenon… but I couldn't afford to take that into account, because couldn't a form of insanity also have caused such a subjective experience? … I digress.)
Point is: research the topic before making claims about what policy should or shouldn't be, especially where persecuted minority groups are concerned. Bigoted sentiment, and lies, that you've picked up from your social environment are not particularly reliable sources of moral guidance.
> Eventually I just had to read up on everything myself
You have something in common with trans people, then. (I swear, the average trans person knows more about endocrinology than the average cis doctor.) The purpose of the medical system is to keep populations in overall good health: it's not great at treating individual issues that aren't immediately life-threatening. (See also: handling acute conditions well, but chronic illness extremely poorly, to the point of denying that it exists at all.)
The medical system is especially not good at dealing with bigotry: the whole system functions on the presumption of good faith, with mechanisms in place to catch specific, individual abuses. Systematic issues, like "let's sterilise the undesirables!" or "let's torture the neurodivergent!" or "let's tell women they're menopausal, or that they need to lose weight, when they present with stroke symptoms", are only addressed once the general consensus is that they need to be addressed. Systematic lifestyle issues, too, are only addressed once there's widespread understanding that they need to be addressed: look at how the "healthy amount of alcohol" keeps getting knocked down a bit, every few years.
Blocking puberty for someone who doesn’t feel comfortable in their body as a child doesn’t guarantee the person will be happy with their now altered body later, medical procedures or not. Most follow up studies seem to indicate the opposite though I’m sure we can cherry pick either way.
Nobody is born their ideal self. It’s a scale and we all suffer from it and have to work on it constantly. There is no magic button to swap someone’s body into their ideal self because at that age they can’t even know what that is; none of us knew before or during puberty. In fact I doubt even adults would know, but at least then you can take legal responsibility and not be manipulated as easily by external influences.
Where are you getting this stuff? I haven't seen a single study indicating that! Dr Hilary Cass's team tried to find a single such study, and at the time of the Interim Cass Review, they'd failed to find any pretext to refuse such medical treatment. (I haven't read the final Cass Review, because by all reports it's bigoted, pseudoscientific twaddle with recommendations that violate the Nuremberg Code.)
You're completely wrong, here. https://slate.com/technology/2024/02/transgender-youth-healt... says much of what I would've said, better: I've talked to a couple of people who've detransitioned, and can confirm that it was entirely due to social pressures. (Not counting gender-fluid folk who've hormonally transitioned 3+ times, since that's better described as "retransition".)
Wovon man nicht sprechen kann, darüber muss man schweigen. (At least until you've learned to distinguish uncomfortable truth from seductive lie.)